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CompletedNCT03469271Updated Sep 26, 2023Results posted

Maintain Respiratory Muscle Function and Reduce Pneumonia Risk in Cancer Patients

A Phase 4 interventional study of 1,25 (OH)2 D3 and Inspiratory isometric resistance training in Cancer, sponsored by Mayo Clinic. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-09-26.

Sponsored by Mayo Clinic · Phase 4, Interventional, and Supportive care

Phase
Phase 4
Study type
Interventional
Enrollment
63
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This research is intended to begin to explore the impact of inspiratory muscle resistance exercise and/or 1,25(OH)2D3 for improving respiratory muscle strength in cancer patients (subjects).

02

Conditions studied

  • Cancer

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Keywords

  • Pneumonia
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Diagnosis of cancer
  • Renal and hepatic function (creatinine \</= 2 x the institutional upper limit of normal; bilirubin \</= 2 x the institutional upper limit of normal)
  • No contraindication to receive either of the planned interventions of inspiratory resistance training or 1,25(OH)2D3 in the opinion of the healthcare provider
  • No difficulties with swallowing oral medications in the opinion of the enrolling physician

Exclusion criteria

Exclusion Criteria:

  • Patient is taking calcium or Vitamin D supplements and is unwilling to stop for 8 weeks
  • Severe chronic obstructive pulmonary disease (oxygen dependent or patient self-reports unable to walk one block without difficulty)
  • Calcium or phosphorus level above the institutional upper limit of normal
04

Study design

Phase
Phase 4
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Factorial assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
63 participants (actual)

Study arms

  • Other
    Training and Placebo

    Inspiratory isometric resistance training with the Threshold Inspiratory Muscle Trainer (IMT) plus oral placebo for eight weeks

    Other: Inspiratory isometric resistance training · Drug: Oral Placebo · Device: Threshold Inspiratory Muscle Trainer (IMT)

  • Other
    Sham Training and Vitamin D3 Metabolite

    Sham inspiratory isometric resistance training with the Threshold Inspiratory Muscle Trainer (IMT) plus 1,25 (OH)2 D3 orally for eight weeks

    Drug: 1,25 (OH)2 D3 · Other: Sham Inspiratory Isometric Resistance Training · Device: Threshold Inspiratory Muscle Trainer (IMT)

  • Other
    Training and Vitamin D3 Metabolite

    Inspiratory isometric resistance training with the Threshold Inspiratory Muscle Trainer (IMT) plus 1,25(OH)2 D3 orally for eight weeks

    Drug: 1,25 (OH)2 D3 · Other: Inspiratory isometric resistance training · Device: Threshold Inspiratory Muscle Trainer (IMT)

  • Other
    Sham Training and Placebo

    Sham inspiratory isometric resistance training with the Threshold Inspiratory Muscle Trainer (IMT) plus oral placebo orally for eight weeks

    Drug: Oral Placebo · Other: Sham Inspiratory Isometric Resistance Training · Device: Threshold Inspiratory Muscle Trainer (IMT)

Interventions

  • Drug1,25 (OH)2 D3

    0.25 micrograms, taken daily for eight weeks, orally

    Also known as: Calcitriol, 1, 25-dihydroxycholecalciferol, Rocaltrol

  • OtherInspiratory isometric resistance training

    A small hand-held reusable device to increase muscle strength and endurance through inhalation therapy. Participants will inhale through a valve which provides resistance that increases the work of breathing and exercises the respiratory muscles.Participants in the active groups will breathe against a resistance set to generate 30% of maximal inspiratory pressure (PImax).

  • DrugOral Placebo

    Placebo will be created to mimic the appearance of the study drug

  • OtherSham Inspiratory Isometric Resistance Training

    A small hand-held reusable device to increase muscle strength and endurance through inhalation therapy. Participants will inhale through a valve which provides resistance that increases the work of breathing and exercises the respiratory muscles. Participants in the sham group will train daily against a resistance set to only 15% PImax.

  • DeviceThreshold Inspiratory Muscle Trainer (IMT)

    A small hand-held reusable device to increase muscle strength and endurance through inhalation therapy. Participants will inhale through a valve which provides resistance that increases the work of breathing and exercises the respiratory muscles.

    Also known as: Threshold IMT Breathing Trainer

05

What researchers measure

Primary outcomes

  1. Sniff Nasal Inspiratory Pressure (SNIP)

    SNIP is a test of maximal inspiratory muscle force exerting from the diaphram. Patients sniff forcefully through one nostril while the other is obstructed. The best of 10 measurements is recorded.

    Time frame: 8 weeks

06

Results

Posted Sep 26, 2023

Participant flow

A study coordinator worked closely with Dr. Jatoi in numerous clinics in the Division of Medical Oncology to identify potential candidates for this study.

Participant flow — Overall Study
MilestoneTraining and PlaceboSham Training and Vitamin D3 MetaboliteTraining and Vitamin D3 MetaboliteSham Training and Placebo
Started16151517
Completed14151516
Not completed2001
Withdrew: Withdrawal by subject2001

Outcome measures

PrimarySniff Nasal Inspiratory Pressure (SNIP)

SNIP is a test of maximal inspiratory muscle force exerting from the diaphram. Patients sniff forcefully through one nostril while the other is obstructed. The best of 10 measurements is recorded.

Time frame:
8 weeks
Reported as:
Mean · cmH20
Sniff Nasal Inspiratory Pressure (SNIP)
cmH20Training and PlaceboSham Training and Vitamin D3 MetaboliteTraining and Vitamin D3 MetaboliteSham Training and Placebo
Sniff Nasal Inspiratory Pressure (SNIP)90 (51 to 190)87 (51 to 159)89 (43 to 150)109 (74 to 153)

Adverse events

Collected over 8 weeks. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Training and Placebo0/16 (0%)0/16 (0%)0/16 (0%)
Sham Training and Vitamin D3 Metabolite0/15 (0%)0/15 (0%)0/15 (0%)
Training and Vitamin D3 Metabolite0/15 (0%)0/15 (0%)0/15 (0%)
Sham Training and Placebo0/17 (0%)0/17 (0%)0/17 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Training and PlaceboSham Training and Vitamin D3 MetaboliteTraining and Vitamin D3 MetaboliteSham Training and PlaceboTotal
<=18 years00000
Between 18 and 65 years1312111551
>=65 years334212
Age, Continuous
Age, Continuous(years)Training and PlaceboSham Training and Vitamin D3 MetaboliteTraining and Vitamin D3 MetaboliteSham Training and PlaceboTotal
Mean52.5 (34 to 72)58 (42 to 81)55 (31 to 74)51 (26 to 75)54 (26 to 81)
Sex: Female, Male
Sex: Female, Male(Participants)Training and PlaceboSham Training and Vitamin D3 MetaboliteTraining and Vitamin D3 MetaboliteSham Training and PlaceboTotal
Female1312131250
Male332513
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Training and PlaceboSham Training and Vitamin D3 MetaboliteTraining and Vitamin D3 MetaboliteSham Training and PlaceboTotal
Hispanic or Latino00000
Region of Enrollment
Region of Enrollment(participants)Training and PlaceboSham Training and Vitamin D3 MetaboliteTraining and Vitamin D3 MetaboliteSham Training and PlaceboTotal
United States1415151660
07

Study locations

1 site
  • Mayo Clinic in Rochester
    Rochester, Minnesota 55905, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Jan 8, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03469271
Lead sponsor
Mayo Clinic
Collaborators
Andersen Foundation
Responsible party
Sponsor
First posted
Mar 19, 2018
Start date
May 25, 2018
Primary completion
May 21, 2020
Completion
May 21, 2020
Results posted
Sep 26, 2023
Last update
Sep 26, 2023

Study contacts

Aminah Jatoi
principal investigator · Mayo Clinic

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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